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  1. Schildmeijer, Kristina PhD, RN

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Eva shuts her front door and shivers. It is early November and only 2 [degrees]C out. The snow is already high. Eva scrapes the ice off her windscreen and contemplates that it looks like it will be a long winter.


Eva's district is in a rural area of southeast Sweden and includes 35 local patients granted home healthcare and one nursing home with 40 patients. Sweden has an aging population; the proportion of people over the age of 65 is about 20%. Her working day starts at 07:30 a.m. when she gets report from the registered nurse (RN) who worked the night shift.


07:45 a.m. Eva reads her to-do list and drives off to the nursing home in the car provided by the municipality. Seven of the 40 patients need help from an RN on this day-wound dressings and loading pillboxes. One patient in a palliative phase needs pain relief and another patient needs an injection.


09:15 a.m. It is time to visit the home patients. Sweden is a sparsely populated country with long distances between homes. Eva makes a route for the day; she'll be driving 150 km. First, she visits an old woman with leg ulcers. They don't look good; one wound looks infected. The woman tells Eva that she also has back pain. An examination shows that the woman has shingles. Eva promises to call the general practitioner during the consulting time between 11:30 a.m. and noon.


10:00-11:30 a.m. Eva visits several patients, including one man whose leg wounds she dresses and another who gets a vitamin B12 injection.


11:30 a.m. Eva calls the general practitioner, as promised, who prescribes treatment for the woman with shingles. Her journey continues. Suddenly, a deer runs across the road and she has to brake rapidly. When Eva's heart rate has calmed down, she reminds herself to be grateful it wasn't a moose.


11:35 a.m. The next patient is a man in a palliative phase. Eva realizes that he is dying and stays to support the wife. This woman has been married and widowed twice before; now she faces the loss of another husband. Eva and the woman talk to each other, but the woman also talks to her husband, holding his hand and singing to him. Soon, the man draws his final breath. As Eva has the authority to pronounce a person dead, she does so. The wife is sad, but not overly sad. "It was a good farewell and a lovely memory for me as well," says Eva.


At 1 o'clock, while eating lunch, Eva receives a phone call. It's a man who tells Eva that he doesn't want to live any more. Eva drives over immediately. The man is suicidal and suffering from severe anxiety. Eva contacts a medical transport, so the man can get to the psychiatric emergency department.


2 p.m. The last visit for this day is far out in the countryside. Eva arrives at a small red wooden house with white trim. It is completely secluded, surrounded by forest. An old couple lives here, each with a pillbox needing to be loaded. They enjoy when RNs come to visit them and want Eva to chat, drink coffee, and try their homemade cheesecake while she is loading their pillboxes.


3 p.m. Eva drives back to the nursing home to document the day as there is no computer in her car. At 4 p.m., she ends her day. As she drives home, it has already begun to get dark. Eva longs for midsummer, when it is bright almost 24 hours a day. Eva finds her job fun and varied. The patients are grateful, especially those living alone, far from urban areas.